Readmissions revisited

I am reposting a post by Garret Johnson and Zoe Lyon, both research assistants for Dr. Ashish Jha at the Harvard T.H. Chan School of Public Health (who also has a great post on risk-adjustment for readmissions. The post eloquently explores an issue I’ve visited in a recent post: the importance of understanding the diverse factors that drive the health outcomes that have become performance metrics. Performance metrics–in this case, hospital readmissions–are intended to reward or penalize providers (hospitals) for the quality of care they deliver. However, these measures are often strongly driven by factors beyond the hospital’s care–patient factors often called “social determinants of health”. The authors state “there is now substantialevidence that high readmission rates — especially for medical conditions, as opposed to surgical ones — are driven more by patient factors outside of hospitals’ control (e.g. poverty, lack of social supports) than by hospitals’ quality of care and discharge planning.”